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Cero C, Lea HJ, Zhu KY, Shamsi F, Tseng YH, Cypess AM. β3-Adrenergic receptors regulate human brown/beige adipocyte lipolysis and thermogenesis. JCI Insight 2021; 6:e139160. [PMID: 34100382 PMCID: PMC8262278 DOI: 10.1172/jci.insight.139160] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
β3-Adrenergic receptors (β3-ARs) are the predominant regulators of rodent brown adipose tissue (BAT) thermogenesis. However, in humans, the physiological relevance of BAT and β3-AR remains controversial. Herein, using primary human adipocytes from supraclavicular neck fat and immortalized brown/beige adipocytes from deep neck fat from 2 subjects, we demonstrate that the β3-AR plays a critical role in regulating lipolysis, glycolysis, and thermogenesis. Silencing of the β3-AR compromised genes essential for thermogenesis, fatty acid metabolism, and mitochondrial mass. Functionally, reduction of β3-AR lowered agonist-mediated increases in intracellular cAMP, lipolysis, and lipolysis-activated, uncoupling protein 1-mediated thermogenic capacity. Furthermore, mirabegron, a selective human β3-AR agonist, stimulated BAT lipolysis and thermogenesis, and both processes were lost after silencing β3-AR expression. This study highlights that β3-ARs in human brown/beige adipocytes are required to maintain multiple components of the lipolytic and thermogenic cellular machinery and that β3-AR agonists could be used to achieve metabolic benefit in humans.
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Affiliation(s)
- Cheryl Cero
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA
| | - Hannah J Lea
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA
| | - Kenneth Y Zhu
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA
| | - Farnaz Shamsi
- Integrative Physiology and Metabolism Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Yu-Hua Tseng
- Integrative Physiology and Metabolism Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Aaron M Cypess
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA
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Seibert JT, Abuajamieh M, Sanz Fernandez MV, Johnson JS, Kvidera SK, Horst EA, Mayorga EJ, Lei S, Patience JF, Ross JW, Rhoads RP, Johnson RC, Lonergan SM, Perfield JW, Baumgard LH. Effects of heat stress and insulin sensitizers on pig adipose tissue. J Anim Sci 2018; 96:510-520. [PMID: 29385474 PMCID: PMC6140977 DOI: 10.1093/jas/skx067] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/21/2017] [Indexed: 01/03/2023] Open
Abstract
Heat stress (HS) negatively impacts several swine production variables, including carcass fat quality and quantity. Pigs reared in HS have more adipose tissue than energetically predicted, explainable, in part, by HS-induced hyperinsulinemia. Study objectives were to evaluate insulin's role in altering fat characteristics during HS via feeding insulin-sensitizing compounds. Forty crossbred barrows (113 ± 9 kg BW) were randomly assigned to one of five environment by diet treatments: 1) thermoneutral (TN) fed ad libitum (TNAL), 2) TN and pair-fed (TNPF), 3) HS fed ad libitum (HSAL), 4) HS fed ad libitum with sterculic oil (SO) supplementation (HSSO; 13 g/d), and 5) HS fed ad libitum with dietary chromium (Cr) supplementation (HSCr; 0.5 mg/d; Kemin Industries, Des Moines, IA). The study consisted of three experimental periods (P). During P0 (2 d), all pigs were exposed to TN conditions (23 ± 3 °C, 68 ± 10% RH) and fed ad libitum. During P1 (7 d), all pigs received their respective dietary supplements, were maintained in TN conditions, and fed ad libitum. During P2 (21 d), HSAL, HSSO, and HSCr pigs were fed ad libitum and exposed to cyclical HS conditions (28 to 33 °C, 58 ± 10% RH). The TNAL and TNPF pigs remained in TN conditions and were fed ad libitum or pair-fed to their HSAL counterparts. Rectal temperature (TR), respiration rate (RR), and skin temperature (TS) were obtained daily at 0600 and 1800 h. At 1800 h, HS exposed pigs had increased TR, RR, and TS relative to TNAL controls (1.13 °C, 48 bpm, and 3.51 °C, respectively; P < 0.01). During wk 2 and 3 of P2, HSSO pigs had increased 1800 h TR relative to HSAL and HSCr (~0.40 and ~0.42 °C, respectively; P ≤ 0.05). Heat stress decreased ADFI and ADG compared to TNAL pigs (2.24 vs. 3.28 and 0.63 vs. 1.09 kg/d, respectively; P < 0.01) and neither variable was affected by SO or Cr supplementation. Heat stress increased or tended to increase moisture content of abdominal (7.7 vs. 5.9%; P = 0.07) and inner s.c. (11.4 vs. 9.8%; P < 0.05) adipose depots compared to TNAL controls. Interestingly, TNPF pigs also had increased adipose tissue moisture content and this was most pronounced in the outer s.c. depot (15.0 vs. 12.2%; P < 0.01) compared to TNAL pigs. Heat stress had little or no effect on fatty acid composition of abdominal, inner, and outer s.c. adipose tissue depots. In summary, the negative effects of HS on fat quality do not appear to be fatty acid composition related, but may be explained by increased adipose tissue moisture content.
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Affiliation(s)
- J T Seibert
- Department of Animal Science, Iowa State University, Ames, IA
| | - M Abuajamieh
- Department of Animal Science, Iowa State University, Ames, IA
| | | | - J S Johnson
- Department of Animal Science, Iowa State University, Ames, IA
| | - S K Kvidera
- Department of Animal Science, Iowa State University, Ames, IA
| | - E A Horst
- Department of Animal Science, Iowa State University, Ames, IA
| | - E J Mayorga
- Department of Animal Science, Iowa State University, Ames, IA
| | - S Lei
- Department of Animal Science, Iowa State University, Ames, IA
| | - J F Patience
- Department of Animal Science, Iowa State University, Ames, IA
| | - J W Ross
- Department of Animal Science, Iowa State University, Ames, IA
| | - R P Rhoads
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA
| | | | - S M Lonergan
- Department of Animal Science, Iowa State University, Ames, IA
| | - J W Perfield
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
- Department of Food Science, University of Missouri, Columbia, MO
- Current Address: Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN
| | - L H Baumgard
- Department of Animal Science, Iowa State University, Ames, IA
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Ferlay A, Chilliard Y. Responses of body fat mobilization to isoproterenol or epinephrine challenge in adult cows: influence of energy level, breed, and body fatness. J Anim Sci 2018; 96:331-342. [PMID: 29378004 PMCID: PMC6140918 DOI: 10.1093/jas/skx020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/15/2017] [Indexed: 12/11/2022] Open
Abstract
The sustainability of livestock production systems facing climatic or economic changes is linked in part to the potential of the female ruminants to adapt to feeding constraints through metabolic and hormonal regulation, notably responses of body fat mobilization, depending on adipose tissue (AT) lipolysis. Our hypothesis was that these responses could change according to genotype (breed) and body fatness. Six fat, nonpregnant, nonlactating Charolais cows, six fat Holstein cows, and six lean Holstein cows were used in a 2 × 2 crossover design with two treatments (underfeeding or overfeeding, at 62% [low] or 128% [high] of maintenance energy requirements [MER], respectively) and two periods. Isoproterenol (ISO, a nonselective β-adrenergic agonist) or epinephrine (EPI, a β- and α2-adrenergic agonist) was injected (6 nmol/kg of lean mass). Blood samples were collected regularly from -20 to 75 min after the injection and then were analyzed for NEFA, glycerol, glucose, and L-lactate. Underfeeding greatly increased (P < 0.001) basal plasma NEFA concentrations (+467%, +264%, and +600% for fat Charolais, fat Holstein, and lean Holstein cows, respectively). For each drug, underfed cows had higher NEFA or glycerol responses to adrenergic challenges than overfed cows. Fat Charolais cows had higher basal plasma NEFA (P < 0.05) concentrations (+64.9%) than fat Holstein cows. The plasma NEFA or glycerol response at 5 min (P < 0.05) was higher for fat Charolais than for fat Holstein cows, whatever the injected drug. Basal plasma lactate concentration and lactate response to ISO or EPI were higher (P < 0.05) for fat Charolais cows than for fat Holstein cows. Fat Holstein cows had higher (P < 0.01) basal glycerol (+18.4%) than lean Holstein cows. This increase could be linked to the increased AT mass. ISO increased more lipolytic responses in fat than in lean Holstein cows, whereas EPI increased more these responses in lean than in fat Holstein cows (drug × fatness interaction), suggesting an increased antilipolytic effect due to α2-AR stimulation in fat cows. Breed had a significant effect on basal and stimulated fat mobilization as well as lactate concentrations, suggesting that the Charolais breed could be more sensitive to stress.
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Affiliation(s)
- A Ferlay
- Université Clermont Auvergne, INRA, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France
| | - Y Chilliard
- Université Clermont Auvergne, INRA, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France
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The blunted effect of glucose-dependent insulinotropic polypeptide in subcutaneous abdominal adipose tissue in obese subjects is partly reversed by weight loss. Nutr Diabetes 2016; 6:e208. [PMID: 27136446 PMCID: PMC4895376 DOI: 10.1038/nutd.2016.15] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/10/2016] [Accepted: 03/20/2016] [Indexed: 01/07/2023] Open
Abstract
Background: Glucose-dependent insulinotropic polypeptide (GIP) appears to have impaired effect on subcutaneous abdominal adipose tissue metabolism in obese subjects. The aim of the present study was to examine whether weight loss may reverse the impaired effect of GIP on subcutaneous abdominal adipose tissue in obese subjects. Methods: Five obese males participated in a 12-week weight loss program, which consisted of caloric restriction (800 Cal day−1) followed by 4 weeks of weight-maintenance diet. Before and after weight loss, subcutaneous adipose tissue lipid metabolism was studied by conducting regional measurements of arterio-venous plasma concentrations of metabolites and blood flow (adipose tissue blood flow, ATBF) across a segment of the abdominal adipose tissue in the fasting state and during GIP infusion (1.5 pmol kg−1 min−1) in combination with a hyperinsulinemic–hyperglycemic clamp. Results: After weight loss (7.5±0.8 kg), glucose tolerance and insulin sensitivity increased significantly as expected. No significant differences were seen in basal ATBF before (1.3±0.4 ml min−1 100 g tissue−1) and after weight loss (2.1±0.4 ml min−1 100 g tissue)−1; however, a tendency to increase was seen. After weight loss, GIP infusion increased ATBF significantly (3.2±0.1 ml min−1 100 g tissue−1) whereas there was no increase before weight loss. Triacylglycerol (TAG) uptake did not change after weight loss. Baseline free fatty acid (FFA) and glycerol output increased significantly after weight loss, P<0.001. During the clamp period, FFA and glycerol output declined significantly, P<0.05, with no differences before and after weight loss. Weight loss increased glucose uptake and decreased FFA/glycerol ratio during the clamp period, P<0.05. Conclusions: In obese subjects, weight loss, induced by calorie restriction, improves the blunted effect of GIP on subcutaneous abdominal adipose tissue metabolism.
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Dobrosielski DA, Barone Gibbs B, Chaudhari S, Ouyang P, Silber HA, Stewart KJ. Effect of exercise on abdominal fat loss in men and women with and without type 2 diabetes. BMJ Open 2013; 3:e003897. [PMID: 24282247 PMCID: PMC3845055 DOI: 10.1136/bmjopen-2013-003897] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To examine the effect of exercise on abdominal adipose tissue in adults with and without type 2 diabetes mellitus (T2DM). DESIGN Post hoc analysis of two randomised controlled trials. SETTING Outpatient secondary prevention programme in Baltimore, Maryland, USA. PARTICIPANTS 97 men and women with prehypertension, stage 1 or medically controlled hypertension. 49% of the sample was also diagnosed with T2DM. INTERVENTION All participants completed a 26-week (6.5 months) supervised aerobic and resistance exercise programme following American College of Sports Medicine guidelines. PRIMARY AND SECONDARY OUTCOME MEASURES The main outcomes in this post hoc analysis were total abdominal adipose tissue (TAT), subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) measured by MRI. Secondary outcomes were to determine whether the magnitude of abdominal fat change differed by diabetes status in men and women and to identify the predictors of change in abdominal fat distribution with exercise. RESULTS Overall, participants (mean age 61±6 years; 45% women) significantly improved peak oxygen uptake by 15% (p<0.01) and reduced weight by 2% (p<0.01). No change in SAT was observed after training. The reduction in VAT following exercise was attenuated in participants with T2DM (-3%) compared with participants who were non-T2DM (-18%, p<0.001 for the difference in change). The magnitude of VAT loss was associated with a decrease in body weight (r=0.50, p<0.001). After adjustment for weight change using regression analysis, diabetes status remained an independent predictor of the change in VAT. CONCLUSIONS Although participants with and without T2DM attained an exercise training effect as evidenced by increased fitness, VAT was unchanged in T2DM compared to those without T2DM, suggesting that these individuals may be resistant to this important benefit of exercise. The strategies for reducing cardiovascular disease risk in T2DM may be most effective when they include a weight loss component. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov Registry NCT00212303.
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Affiliation(s)
- Devon A Dobrosielski
- Department of Kinesiology, Towson University, Towson, Maryland, USA
- Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sameer Chaudhari
- Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pamela Ouyang
- Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Harry A Silber
- Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kerry J Stewart
- Division of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Frayn KN, Karpe F. Regulation of human subcutaneous adipose tissue blood flow. Int J Obes (Lond) 2013; 38:1019-26. [PMID: 24166067 DOI: 10.1038/ijo.2013.200] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/12/2013] [Accepted: 09/21/2013] [Indexed: 12/14/2022]
Abstract
Subcutaneous adipose tissue represents about 85% of all body fat. Its major metabolic role is the regulated storage and mobilization of lipid energy. It stores lipid in the form of triacylglycerol (TG), which is mobilized, as required for use by other tissues, in the form of non-esterified fatty acids (NEFA). Neither TG nor NEFA are soluble to any extent in water, and their transport to and out of the tissue requires specialized transport mechanisms and adequate blood flow. Subcutaneous adipose tissue blood flow (ATBF) is therefore tightly linked to the tissue's metabolic functioning. ATBF is relatively high (in the fasting state, similar to that of resting skeletal muscle, when expressed per 100 g tissue) and changes markedly in different physiological states. Those most studied are after ingestion of a meal, when there is normally a marked rise in ATBF, and exercise, when ATBF also increases. Pharmacological studies have helped to define the physiological regulation of ATBF. Adrenergic influences predominate in most situations, but nevertheless the regulation of ATBF is complex and depends on the interplay of many different systems. ATBF is downregulated in obesity (when expressed per 100 g tissue), and its responsiveness to meal intake is reduced. However, there is little evidence that this leads to adipose tissue hypoxia in human obesity, and we suggest that, like the downregulation of catecholamine-stimulated lipolysis seen in obesity, the reduction in ATBF represents an adaptation to the increased fat mass. Most information on ATBF has been obtained from studying the subcutaneous abdominal fat depot, but more limited information on lower-body fat depots suggests some similarities, but also some differences: in particular, marked alpha-adrenergic tone, which can reduce the femoral ATBF response to adrenergic stimuli.
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Affiliation(s)
- K N Frayn
- Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK
| | - F Karpe
- 1] Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK [2] National Institute for Health Research, Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK
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KOPPO K, VALLE C, ŠIKLOVÁ-VÍTKOVÁ M, CZUDKOVÁ E, DE GLISEZINSKI I, VAN DE VOORDE J, LANGIN D, ŠTICH V. Expression of Lipolytic Genes in Adipose Tissue Is Differentially Regulated During Multiple Phases of Dietary Intervention in Obese Women. Physiol Res 2013; 62:527-35. [DOI: 10.33549/physiolres.932483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to investigate the time-course of the expression of key lipolysis-regulating genes in the subcutaneous adipose tissue (SCAT) during different phases of a 6-month dietary intervention. Fifteen obese women (BMI 34.7±1.0 kg.m-2) underwent a 6-month dietary intervention consisting of 1 month very low calorie diet (VLCD), followed by 2 months low calorie diet (LCD) and 3 months weight maintenance diet (WM). At each phase of the dietary intervention, a needle microbiopsy of the abdominal SCAT was obtained to evaluate mRNA expression of key lipolysis-regulating genes and a hyperinsulinemic euglycemic clamp (HEC) was performed. Dietary intervention induced a body weight reduction of 9.8 % and an improvement of insulin sensitivity as assessed by a HEC. Compared to pre-diet levels, mRNA levels of the adrenergic β2-receptor in SCAT were higher at the end of VLCD and not different at the end of LCD and WM. In contrast, the expression of the adrenergic α2-receptor was lower at the end of VLCD and LCD compared to the pre-diet levels and did not differ at WM. Adipose triglyceride lipase and hormone-sensitive lipase levels were lower than the pre-diet levels at the end of LCD only, while phosphodiesterase-3B and the insulin receptor levels did not change throughout the dietary intervention. The results suggest that the regulation pattern of the genes that are involved in the control of lipolysis is different at the respective phases of the dietary intervention and depends on the duration of the diet and the status of energy balance.
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Affiliation(s)
- K. KOPPO
- Department of Sports Medicine, Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Marques MA, Combes M, Roussel B, Vidal-Dupont L, Thalamas C, Lafontan M, Viguerie N. Impact of a mechanical massage on gene expression profile and lipid mobilization in female gluteofemoral adipose tissue. Obes Facts 2011; 4:121-9. [PMID: 21577019 PMCID: PMC6444793 DOI: 10.1159/000327347] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Gluteofemoral adipose tissue areas are known to be poorly metabolically reactive. Mechanical massage has previously been reported to show morphological and functional impact on this tissue. The present study was carried out to delve more deeply into the mechanistic considerations regarding the incidence of a mechanical massage technique on gene expression profile and β-adrenergic-mediated lipid mobilization in female femoral adipose tissue. METHODS Twelve premenopausal healthy women were included and received 12 sessions of calibrated mechanical massage (Endermologie®). Total RNA was extracted from femoral adipose tissue biopsies for gene expression studies. Microdialysis was carried out in the femoral adipose tissue in order to assess lipolytic responsiveness (via glycerol determination) and changes in local blood flow following perfusion of a lipolytic agent, isoproterenol. Evaluations were performed before and after the 6-week experimental period. RESULTS Mechanical massage initiated important modifications in gene expression profile. The lipid-mobilizing effect of isoproterenol was enhanced after the experimental period. Basal local blood flow and isoproterenol-induced vasodilatation were also improved. CONCLUSION The protocol of mechanical massage used in the study promoted noticeable changes in the expression of genes involved in metabolic pathways. The lipolytic and local adipose tissue blood flow responses initiated by isoproterenol were significantly enhanced.
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Affiliation(s)
- Marie-Adeline Marques
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- IFR150, Biomedical Research Federative Institute of Toulouse, Paul Sabatier University, University of Toulouse, Toulouse
| | - Marion Combes
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- IFR150, Biomedical Research Federative Institute of Toulouse, Paul Sabatier University, University of Toulouse, Toulouse
| | - Balbine Roussel
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- IFR150, Biomedical Research Federative Institute of Toulouse, Paul Sabatier University, University of Toulouse, Toulouse
| | | | - Claire Thalamas
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- Clinical Investigation Center Inserm CIC-9302, University Hospital Centre of Toulouse, France
| | - Max Lafontan
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- IFR150, Biomedical Research Federative Institute of Toulouse, Paul Sabatier University, University of Toulouse, Toulouse
| | - Nathalie Viguerie
- Inserm, UMR 1048, Obesity Research Laboratory, Cardiovascular and Metabolic Medicine Institute
- IFR150, Biomedical Research Federative Institute of Toulouse, Paul Sabatier University, University of Toulouse, Toulouse
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Bobbioni-Harsch E, Sztajzel J, Barthassat V, Lehmann TNO, Sievert K, Chassot G, Huber O, Morel P, Golay A, Assimacopoulos-Jeannet F. The effect of insulin on cardiac autonomic balance predicts weight reduction after gastric bypass. Diabetologia 2005; 48:1258-63. [PMID: 15937670 DOI: 10.1007/s00125-005-1792-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Accepted: 03/06/2005] [Indexed: 11/24/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to assess the predictive role of autonomic reactivity in body weight loss induced by gastric bypass. METHODS A group of 22 morbidly obese subjects, who were due to undergo a gastric bypass, were submitted, before surgery, to a euglycaemic-hyperinsulinaemic clamp, during which a continuous recording of the ECG was performed. The effect of insulin on cardiac autonomic balance was evaluated by performing power spectral analysis of heart rate variability. The low-to-high frequency ratio was calculated before and during the clamp and its modifications were expressed as % delta low-to-high frequency ratio (%Delta L: H). RESULTS Preoperative %Delta L: H showed a significant (p=0.0009, r2=0.43), positive relationship to the reduction of body weight, measured 1 year after surgery and expressed as % excess weight loss (% EWL). Preoperative BMI was also significantly (p=0.0009, r2=0.43) negatively related to the 12-month % EWL. In a multiple regression analysis, %Delta L: H remained a significant (p=0.003), independent predictor of body weight loss, even when preoperative BMI or age, % fat mass, insulinaemia and glucose disposal were taken into account. CONCLUSIONS/INTERPRETATION The best correction of excess body weight was achieved by those obese subjects who had a preserved capacity to shift their cardiac autonomic balance towards a sympathetic prevalence in response to an euglycaemic-hyperinsulinaemic clamp. Further studies are needed to elucidate the mechanisms through which the autonomic nervous system influences weight reduction.
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Affiliation(s)
- E Bobbioni-Harsch
- Service of Therapeutic Education for Chronic Disease, Geneva University Hospital, 1211, Geneva, Switzerland.
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